Thus far, most coverage, and the government announcements on which the coverage is based, have ignored two unpleasant truths -- first, that it is unlikely the health care delivery system will be able to respond to a significant flu wave and second, that the economy is likely to be severely affected by a widespread and long-lasting flu surge.

Thus far, government planning to meet these two challenges has been spotty at best. The truth is, gaps in the health care delivery system need to be filled and planning to address the economic impact of a flu surge needs to begin soon.

Challenge to the Health Care Delivery System

The facts are, over the next month the U.S. health care system will be challenged by a relatively benign influenza surge that will test the federal government's ability to efficiently deliver drugs and vaccines where they are needed. Every level of government and the private sector will need to operate and cooperate to meet the flu challenge and minimize its impact on people's health.

Large numbers of people, over an extended period of time, are expected to become sick during the expected H1N1 flu surge. Sadly, it is possible that many will die. Within the last week, two government agencies were bickering over the facts of the expected death toll. Early last week, the President's Science Advisory Council issued a report estimating between 30,000 and 90,000 deaths. Later in the week, the Centers for Disease Control (CDC) said the 90,000 number was overstated.

The truth is, estimating the death toll grabs headlines, but it is not as important as planning to minimize the suffering from disease.

We have seen no specific plans for identifying where outbreaks are occurring, how severe they may be, how to determine how much of the critical supplies should be sent to those areas and how they will get into the hands of medical personnel in hospitals and doctors' offices. The truth is, without such plans, needed supplies will be shipped where they are not needed, while places where they are needed will go without.

Too Late to Prepare?

The only way we can affect the suffering from this disease is to assure that the stockpiles of anti-viral drugs (Tamiflu and Relenza) are released by governments in a timely manner and delivered to patients within 48 hours of the onset of symptoms, when they can do some good.

The most effective way to prevent the spread of the disease is vaccination, and only limited vaccine supplies will be available starting mid-October, which may be too late to stem the tide. As of today, we have seen no plans for identifying where the vaccine is most needed and getting whatever vaccine is available to people who are at risk in a timely manner.